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Vol.49 No.6 contents | Japanese/English |
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- Case Report -
Large Cell Lung Cancer Complicated with Chronic Myelogenous Leukemia
Hidehito Matsuoka1, Takeshi Hatta1, Takeyuki Kushima21Department of Surgery, 2Department of Radiology, Hyogo Prefectural Awaji Hospital, Japan
Background. Large cell lung cancer is seldom complicated with chronic myelogenous leukemia (CML). Case. A 59-year-old CML man who had received chemotherapy for 3 years with 400 mg imatinib mesylate per day presented because a 50×45 mm tumor shadow was found in the right upper lobe on a chest X-ray film. Chest computed tomography showed right hilar lymphadenopathy and severe emphysematous change. Spirometry revealed mild obstructive change. The mass was diagnosed as primary lung cancer by bronchofiberscopy. A right upper lobectomy with ND2a lymph node dissection was performed without stopping imatinib mesylate intake. The postoperative diagnosis was T2N2M0, p-stage IIIA large cell cancer with single tracheobronchial lymph node metastasis. Moderate edema was observed on the face and upper limbs on the second postoperative day, but twice daily dose of 20 mg furosemide improved the edema within 2 days. Insertion of a cricothyroidotomy needle (Trahelper®) enabled removal massive sputum. The patient had no other complications and was discharged on the 20th postoperative day. Conclusion. Imatinib mesylate is highly effective in most patients with CML. Patients who respond well to imatinib mesylate are likely to live substantially longer than those who are not treated with previous therapies. Therefore imatinib mesylate is indicated in certain cases of malignant diseases including lung cancer. However caution is needed because imatinib mesylate may develop some unexpected complications such as large cell lung cancer in the postoperative period and there are few data about combination use of imatinib mesylate and other cytotoxic agents.
key words: Chronic myelogenous leukemia, Primary lung cancer, Imatinib mesilate, Postoperative complication
Received: August 22, 2008
Accepted: April 22, 2009
JJLC 49 (6): 844-846, 2009
